Indian Women, Relationships and Mental Health

A lot is being said about women, their multiple roles and the pressures that they face on a day to day basis due to their commitments within the family and at work. This article is an attempt to analyze the various emotional issues that Indian women face.

The Girl Child

Though the girl child is welcomed by many families as a blessing, there is often a sense of responsibility and burden that accompanies the event. Why is this so? There are many often quoted reasons: worry regarding dowry, the thought that a girl will not be able to support the family financially and emotionally, worries regarding the safety of a girl child. The latter seems to be a growing concern among people nowadays. And this is justified. The reports are staggering - 322000 crimes against women perpetrated in 2014 amounting to 882 crimes a day (reference NCRB 2014). The corresponding figures for men are not available but it is safe to assume that sexual violence against adult men is lower than that against women. The same however is not true for boys and girls and the rate of sexual violence seems similar in this category indicating that that vulnerability may be one of the underlying factors.

Now how does this sense of burden affect the dynamics in the family and particularly the girl child? There is usually a lot of conversation in families about what a girl "should and should not do" and the "big bad world" leading to a sense of fear and apprehension in the child's mind. This may lead the child to feel that she is vulnerable, not capable of defending herself and that she is powerless and that her male counterparts are more powerful than her. There is a bias in the involvement of the girl child in decision making in the family as the family considers her an "outsider" (haven't we all heard our mothers say "beti paraaya dhan hoti hai"). This results in the girl child seeking help or delegating decision making responsibilities to her male counterparts. Hence, she becomes the "worker" in the home. This is not to say that all girls are made to do household chores, but a sense that this will be what is expected of her is instilled at a very young age as is a sense that she needs to listen and abide by what her male counterparts say.

This has a definite effect on the child's sense of self-esteem and independence and also her sense of trust on others.

Defining of gender roles also instils a sense of having to be "womanly and beautiful" the notion of which is defined by the patriarchs of the society. So, men in America decide that their women have to be "0" figured and wear makeup and men in India decide that women have to be soft-spoken, beautiful and those who are "marriageable material" have to wear certain kinds of dresses and be a certain way, whereas those women who do not that have to be more western in their attire! So in the end, a girl is made to feel that she owes it to society to be a certain way whereas these rules don't apply to her male counterparts anywhere around the world.

So the girl child grows up usually worrying about or despising her body again leading to low self-esteem.

The young adolescent/lady

As the child grows into a young lady and if she is fortunate enough to be amongst the 35% in urban areas to be enrolled in higher education, there are more challenges that she will be facing.

Discrimination against women in universities is rampant and often women have to dumb themselves down to not "intimidate" their male professors (and even female professors). Women quickly find themselves addressed with nicknames which are often derogatory and often refrain from being "too social". This is not the case for the male counterparts who enjoy a freedom that women can only dream of as of now in India.

Then comes the job interviews. Out of the 35 % who graduate, only 25% get employed. Many get married early and many just don't get the jobs. On an average, women are paid less than their male counterparts as well.

It can be easily understood that all this leads to the women wearing a mask in society, often not being who she really is for the fear of being judged. This can take a toll on the emotional health.

Marriage and pregnancy

Marriage is a daunting event in anyone's life but for a woman, it is more than that. It is a whole life transition. She is severed from her social supports, her family, sometimes her city and pushed into a new family to adjust to a completely new setting where she will be responsible for the new family. She walks into a hostile environment as it is very likely that the husband's family will judge her according to their standards, not understanding her background or her needs. A nuclear family will still mean that she will have to have more contact with her in-laws than her husband has with his and will be expected to host the in-laws as and when they want. I personally believe in the joint family system especially due to work pressure on the parents nowadays but the joint family should not come at the cost of the woman's freedom of speech or rights. The in-laws and husband must understand that the lady has made a very difficult transition and must not expect her to live their life. They must allow her time to adjust to the new environment and make the transition as smooth as possible by being supportive and not critical. The lady's parents must be as close to the family as the husband's parents. If these are not the case, the woman feels isolated and belittled. If the spouse does not give weight to the wife's opinion and unduly and irrationally supports his own family of origin, she will feel let down and will further lose self-esteem. This may push her into a depression.

Pregnancy is another transition in a woman's life which is not as taxing for a man. Biologically, her body goes through a turmoil of hormonal surges and changes in body fluids. Her sleep patterns change and her body image takes a hit. This can be a period of great joy and emotional growth for both the woman and her spouse if the responsibility is shared and the changes are understood by the spouse and his family and she receives the support she deserves. However, it can be a dark hole of emotional upheaval if the opposite happens. Pregnancy blues and depression are very common and recognized emotional issues - 1 in 2 women suffer blues whereas 1 to 2 in 10 will suffer full-blown depression.

Depression during and after depression is very common but underdiagnosed

An article in The Wire dated 29/12/2016 brings out the issue of postpartum depression being under-diagnosed and that often the Indian women do not know that their distress is legitimate and has a name for it. Many women fear stigmatization if they talk about not being joyous after the birth of the baby and hide their distress leading to suffering and further damage to their psyche. Furthermore, 1 in 1000 women will suffer a more severe illness- postpartum psychosis. This is a dangerous condition for both the mother and the baby as it may lead to delusions of the child not being her own or being unwell which may lead the mother to harm the child and herself. This is considered a psychiatric emergency. However, very few cases are reported, mainly due to under-diagnosis and under-reporting.

The main causes for partum and postpartum illnesses are not only the biological changes in the woman's body but the sociocultural environment and support she receives.

Career goals and relationships

A working woman faces many challenges. She has to juggle several roles of the career woman, the mother, the wife, the daughter in law. The man, on the other hand, usually has only his career to consider and the other roles are less demanding on him due to the cultural and gender divide. Though a man is a father, a husband and a son, his role as a career man takes precedence over other things and social sanctions that whereas with a woman, every single role is as important as the other and society looks upon her career aspirations as dispensable. If a woman gives as much importance to her career as a man, she is considered selfish. The demands of so many roles and the unfairness of the preferential treatment towards men both at the workplace and at home lead to frustration among the women and they may suffer from a sense of guilt over whatever they do as they feel inadequate in each role leading to low self-esteem, depression and anxiety.

Menstruation and Menopause

Menstruation and associated mood swings are other aspects of a woman's life that a man may not understand. Often Premenstrual syndrome is the butt of jokes but it is a real issue which causes turmoil for a woman. In a systematic review and meta-analysis of the prevalence of Premenstrual syndrome (J Clin Diagn Res. 2014 Feb), it was found that 30 to 40% women of reproductive age group (puberty to menopause) suffer from it.

Another life transition that is unique to women in menopause. Anxiety and depression are common during premenopause and menopause. The rising health risks postmenopause may also lead to sudden deterioration in the quality of life of a woman after menopause.

Change required

So we have listed a few of the challenges faced by women and the emotional aspects of it. What change can we initiate to overcome these problems?

Societal and cultural changes are paramount to the emotional health of women. As long as the patriarchs in society are dominant and the voice of women is suppressed, there will be emotional problems. Equal opportunities and equality in all aspects!

Support, understanding and clear communication between couples and their extended families and curbing preferential treatment of men within the family will help overcome marital and marriage-related issues.

Men and women sharing the responsibilities of different roles will lead to better emotional health within the family and will also lead to good parenting for the children who are victims of the power struggles within families.

The understanding of the biological differences between men and women and to stop the deriding of valid emotional issues of women would go a long way in the emotional health of women.

Women have the unique power and gift of bearing a child. The growth of a child in the womb of a woman is a sacred blessing. The protection of the fetus is the responsibility of both parents, so no smoking, drinking, no unnecessary stress during that period. The child did not ask to be born so both man and woman have no right to put it through unnecessary trouble and turmoil.

Better pregnancy and post-pregnancy mental health care for women and their spouses will lead to early diagnosis and treatment of depression, postpartum psychosis and other issues.

Disclaimer: This article is researched but also includes the individual opinion of the author. It is not intended to hurt the sentiments of any gender or community.